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Neurology (Expert Forum)
QUESTION ABOUT RADICULOPHATHY AND NERVES
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QUESTION ABOUT RADICULOPHATHY AND NERVES
by freedom1776, Feb 06, 2006 12:00AM
I have had extensive spinal surgery over the last 10 years. One of the symptoms that I had previously was L4 and L5 radiculophathy. The symptoms had went away following a previous surgery. However, after a recent surgery which affected the same spinal area the symptoms have returned as before. I understand that the nerves are a very complex thing but can nerves be re-injured and why is there so much uncertainty as to if and when a nerve will rejuvenate? I notice that relaease forms conclusively do not really promise anything in the way of relief and in fact state that a worsening of symptoms can occur. Is this sdue to the complex nature of some surgeries? Also, do some nerves never really heal or return to normal functioning again? Thank you.
Doctor's Answer
by CCF-Neuro-M.D.-PW, Feb 11, 2006 12:00AM
Nerves can be injured either mechanically (transection or compression) or from a lack of blood supply/nutrients/toxins (like a neuropathy).
The prognosis for recovery depends on the degree of damage and the duration over which damage was occurring - hence the wide variation in recovery of nerves after injury. Injury to the sheath of the nerve (the myelin) means that the nerve will almost always recover. Injury to the nerve itself (the axon) means that there is a chance that the nerve will be permanently damaged. Nerve can regrow if they are still connected to the nerve cell body in the spinal cord, although regrowth occurs very slowly (like less than 1mm per day) - the nerve will only regrow if it is still connnected to its origin in the spinal cord. Also, after 12-18 months the parts of the nerve farthest from the origin that the regrowth has not reached will die and further recovery is unlikely to recur.
How can we tell what kind of damage and how much has occurred. The clinical examination can sometimes give a clue - deficits that do not recover over time suggest axon damage. EMG and nerve conduction studies can also give clues to this.
If the nerve is re-exposed to the injurious agent, further damage can occur (for instance a disc fragment or recurrent stenosis after surgery)
Good luck
The prognosis for recovery depends on the degree of damage and the duration over which damage was occurring - hence the wide variation in recovery of nerves after injury. Injury to the sheath of the nerve (the myelin) means that the nerve will almost always recover. Injury to the nerve itself (the axon) means that there is a chance that the nerve will be permanently damaged. Nerve can regrow if they are still connected to the nerve cell body in the spinal cord, although regrowth occurs very slowly (like less than 1mm per day) - the nerve will only regrow if it is still connnected to its origin in the spinal cord. Also, after 12-18 months the parts of the nerve farthest from the origin that the regrowth has not reached will die and further recovery is unlikely to recur.
How can we tell what kind of damage and how much has occurred. The clinical examination can sometimes give a clue - deficits that do not recover over time suggest axon damage. EMG and nerve conduction studies can also give clues to this.
If the nerve is re-exposed to the injurious agent, further damage can occur (for instance a disc fragment or recurrent stenosis after surgery)
Good luck
I`m a Brazilian Physical Therapist, and i read your question...
Its very important for this kind of surgery (low back surgery) for Radiculophaty the reason for the pain.. Tha radicuphaty has many reasons,Compressive, Inflammatory, Infectious , Isquemic , Neoplasics and Traumatics...
So, its important first of all search the real problem for the Radiculophathy.
The pain lessens when the doctor releases the pressure into the nerve, but more important than that, is to find the reason that the pain is happening....
Try to find a Good doctor, or u can make lots of another surgerys without good results....
Sorry again for my bad english... hope i could help you..
Mauricio COuto